Individual
MR. CARLOS MARSHALL JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
177 E 192ND ST, EUCLID, OH 44119-1025
(216) 867-4557
Mailing address
177 E 192ND ST, EUCLID, OH 44119-1025
(216) 867-4557
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
161552
OH
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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